title: Management of painful pelvic bone metastasis of renal cell carcinoma using embolization, radio-frequency ablation, and cementoplasty: a prospective evaluation of efficacy and safety.
abstract: OBJECTIVE
  To measure the impact on pain relief and patient quality of life using embolization radio-frequency ablation and cementoplasty (ERC) for local combination therapeutic management of painful pelvic bone metastasis of renal cell carcinoma (RCC).
  
  
  METHODS
  This prospective monocentric registry was approved by our Local Institutional Review Board. Between January 2008 and January 2013, all consecutive patients who fully met the inclusion criteria were enrolled in the ERC-procedure prospective registry. They were assigned to follow-up at discharge and again at 1 and 6 months. Efficacy was evaluated using a pain visual analog scale (VAS), and narcotic consumption and quality of life were assessed using the Brief Pain Inventory questionnaire.
  
  
  RESULTS
  Fifty-two patients were enrolled, among whom 58 lesions were treated. Technical success was obtained in all procedures. The median VAS score decreased from 7 ± 1.4 (ranges 5-10) at baseline to 3 ± 1.5 (ranges 0-6) at discharge, 2 ± 1.5 (ranges 0-5) at 1 month (p < 0.0001), and 2 ± 1.6 (ranges 0-5) at 6 months. In 28 patients (54 %), narcotic consumption was halved at discharge and halved in 40 (77 %) patients at 1 and 6 months compared with baseline. Five patients had complete pain relief at 1 month. A major improvement in quality of life, especially regarding mood and motion, was observed in all patients.
  
  
  CONCLUSIONS
  This specific approach to painful bone metastasis is efficient and safe and yields sustained results. The ERC procedure could be suggested for patients with RCC bone metastasis.
authors.affiliation: Faculté de Médecine, Université Paris Descartes - Sorbonne Paris Cité, Paris, France, olivier.pellerin@egp.aphp.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Pellerin
authors.forename: Jacques
authors.initials: J
authors.lastname: Medioni
authors.forename: Claire
authors.initials: C
authors.lastname: Vulser
authors.forename: Carole
authors.initials: C
authors.lastname: Déan
authors.forename: Stéphane
authors.initials: S
authors.lastname: Oudard
authors.forename: Marc
authors.initials: M
authors.lastname: Sapoval
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy*; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000628:therapy*; D017115:Catheter Ablation; D060826:Cementoplasty; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010384:Pelvic Bones / Q000473:pathology*; D017699:Pelvic Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D011846:Radio Waves; D012042:Registries; D011795:Surveys and Questionnaires